Bonus – Passing the Esophageal Temperature Probe

I was drinking beers with my friend Oren Friedman, a medical intensivist with an interest in hypothermia; we got to talking about how it can be a b*tch to pass the esophageal temperature probe for hypothermia. I had recorded some footage for our hypothermia video a while back on how to get er done.

Comments

Nope, nasopharyngeal is pretty useless. If you have a rectal prbe, then you have an esophageal probe; I have never seen one that is not for both sites. Just make sure you don’t go from rectal to esophageal without a probe change in between. If you had neither of these, bladder is the next best.

Hi Scott,
I use the same technique to get in the orogastric in the trauma patient. My only other tip is to use the scardest / most highly strung student / juniour MO you can find to do the “intubation” – 100% guaranteed to get ti in the oesopagus!!
Casey

A couple years ago we replaced our firm, moldable NG tubes with shitty limp ones that resemble esophageal temperature probes; often difficult to insert. Since then I’ve been using a similar method:

1. Cut an ETT lengthwise. I don’t carry a rescue hook so I use a scalpel, works much better than scissors/shears.

2. Perform laryngoscopy.

3. Place a bougie in the esophagus.

4. Railroad split ETT over bougie. Remove bougie.

5. Insert least expensive NGT in the world into ETT.

6. Withdraw ETT to end of NGT, then shed ETT using split.

This method gives residents practice doing laryngoscopy in an already-intubated patient, so they can take their time and build muscle memory, practice using the bougie, and is much faster than the usual struggle, with NGT coiling in mouth, xrays that show no NGT in the stomach, etc.

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Who am I?

Hi, my name is Scott Weingart. I am an ED
Intensivist from New York City. My career goal and the purpose of this blog and podcast is to bring Upstairs Care, Downstairs-–that is to bring ICU level care to the ED, so our patients can receive optimum treatment the moment they roll through the door.